Morbidity and mortality in pregnant and labor women are the major problems in developing countries. The maternal mortality rate in kendari city has readed 6.27 per 100,000 live birth in 2013. This aim of this study was to the effect of the referral process to maternal mortality in kendari city. This research was analytic observational with case control design. The Samples of this study were 25 pregnant women who were referred to kendari city and death. The case controls were 50 pregnant women who were referred to kendari city who did not experience death. Techniques of data collection using secondary data from the register book NME and medical records and interviews with the mother / family / husband of respondents.The data was analyzed by using univariable, bivariable and multivariable analysis with logistic regression. The results of this study confirmed that there ferral process was poor (OR=9,783,95% CI: 2,275 to 42,072, p=0,002).thus, the incidencematernal mortality increased. The conclusion of this study is the referral process to maternal mortality affect the occurrence of maternal mortality. Suggestions can be drawn based on the results of this study. First, health education should be given to women in their productive age. Secoundly, the quality of ANC and the quality of referrals should be improved by creating a close referral system in a region associated with a high risk pregnant women were detected inventoried and scheduled control/termination and monitored (follow-up) sothat high risk always monitored
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